Conquering our COVID-19 fears


By Rafael Castillo M.D.


I was trying to reconcile the stats on why some hospitals are reporting near maximum occupancy in their new coronavirus disease (COVID-19)-allocated beds. Yet, when you look at the figures released by the Department of Health (DOH), the percentages of critical cases are only 0.1 percent, and for severe cases, 0.6 percent.

It means 99.3 percent of the remaining active cases are either mild or asymptomatic cases, which don’t require hospitalization. They could just be isolated either in their own homes, or in the facilities prepared by local government units.

In terms of actual numbers, critical cases which require admission into intensive care units (ICU) and needing mechanical ventilators or breathing machines total only 36, while severe cases which may also require ICU admission but not necessarily mechanical ventilators number around 220.

We have a total of 1,295 ICU beds and 1,993 ventilators. So, if the figures are to be reconciled, we should have only around 20 percent of ICU beds occupied, and, at most, 10 percent of ventilators in use.

However, in the same DOH report, 560 ICU beds (43.3 percent) are occupied, and 450 ventilators (22.3 percent) are being used. These figures are more than double the actual number of patients reported.

The DOH should explain this discrepancy, so we’ll know exactly where we stand. People are starting to panic again, like we all did in March and April, but I think it’s not as bad as it seems. It’s expected that we’ll really have more confirmed new cases with the increased number of suspected cases being tested.

Vigilant

We have to remain vigilant, with people getting listless and reckless, not following prescribed precautions of wearing face masks and face shields, physical distancing and hand hygiene properly.

Always bear in mind the immune-system-boosting regimen of adequate sunshine, mild to moderate intensity exercises, seven to eight hours of sleep, stress management and our recommended supplemental pills.

Even with these precautions, one may still catch the virus, but the viral load is low, which can be easily overcome by the body’s immune system. One may not even know he has already beaten COVID-19. Just this past week, I knew of eight cases with positive antibodies after routine testing required by their companies. Yet they’re all symptom-free.

In fact, my recommendation is to get the young (55 years and younger), able-bodied people to go out and work and get the economy revved up, while the more senior ones and those with risk factors like hypertension, diabetes, chronic lung problems and other medical conditions associated with weakened immune systems should just stay home or work from home and maintain distance with family members who come home from work.

It’s not really losing the COVID-19 war if there are more new cases, so long as the number of those developing severe or critical conditions and dying is kept at bay. So far, the death rate has remarkably gone down from a high of around 8 percent at the start of the pandemic to less than 1 percent in the last several weeks. The DOH should report this figure to reassure everyone that out of 167 Filipinos confirmed with COVID-19, only one will die, while 166 will either be symptom-free or have mild symptoms.

Just to put things in perspective, every month, 12,000 to 15,000 Filipinos die of heart attack, stroke and other cardiovascular causes. Yet we don’t feel the same anxiety and fear as we feel with COVID-19.

I dare say, now that we know much better how to treat COVID-19 patients, the death rate is no higher than that of the seasonal flu. It’s just that COVID-19 is more infectious than the flu virus.

Epidemiologic testing

In this column I’ve been recommending that we do periodic epidemiologic testing representative of the whole country to determine the actual number of people who had developed antibodies to the virus, indicating that they already got infected by the virus and recovered without them realizing it. I figure that it should be at least 50 times the number of reported confirmed cases we have. That would be around 2 million Filipinos.

That number is still far from the number that will provide us herd immunity—around 70 percent of the population or more than 70 million—but if we can see that the number of people getting the virus with no symptoms or just mild symptoms is progressively increasing vis-a-vis those with severe infection, then the government will have a stronger basis to allow more economic, educational, religious and social activities.

With a scientific sampling technique, it will probably require no more than 5,000 people to be tested to get a fairly good picture of the extent of the outbreak in the whole country, and in every region. We can do it monthly in the first three months, then quarterly thereafter. If we have this regular nationwide testing, we don’t even need the daily stats anymore, which only results in a rollercoaster of emotions as we learn of the peaks and plateaus.

Fairly safe

No one can really say when this pandemic will end. We have yet to see the light at the end of the tunnel, but we just can’t stay inside the tunnel indefinitely. Many Filipinos are going out and trying to earn a living, rather than being safely quarantined in their dwellings but having to endure poverty-related complications.

It’s with these people in mind that I decided to resume seeing patients and fulfilling my other commitments. It’s to show solidarity with our working class and to show others that it’s fairly safe to go back to work if we maintain strict precautions.

Since I’m a senior with maintenance medicines for hypertension, people ask me if I’m not afraid to catch the virus. I simply reply that I’d like to walk my talk.

I keep telling readers that we can defeat the virus with a proper mindset, and I have to show that by doing as I say. I wear a face mask and transparent face shield when I go to work. I put on complete PPE when I have to examine patients thoroughly and listen to their heart sounds, so I’m practically just a foot away from them.

On two occasions, I saw patients who had atypical symptoms—one just had a stuffy nose, and the other a vague feeling of malaise. When in doubt, I request for a COVID-19 swab. Both turned out to have positive COVID-19 swabs. The second one was more than two weeks ago, so I’m good, I’m safe. Praise God.

Conquering our COVID-19 fears takes some getting used to. Every morning, when I wake up with a clear unobstructed breath, I thank God for blessing us with another day closer to declaring triumph over the unseen enemy.
Source: https://lifestyle.inquirer.net/366203/conquering-our-covid-19-fears/#ixzz6TWvytYxQ

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